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Initiative Petition for Charter AmendmentCITY CHARTER AMENDMENT INITIATIVE PETITION We, the undersigned qualified electors of the City of Miami Beach, Florida, do hereby petition the City of Miami Beach Commission to submit to the qualified electors of Miami Beach the following amendment to the Miami Beach City Charter: (INSERT TEXT OF PROPOSED CITY CHARTER AMENDMENT) ________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ Sign and print name Street Address (include City and State) Date of Birth OR Voter Registration No. Date signed (include day, month and year) Sign:________________________ Print: Sign:________________________ Print: Sign:_________________________ Print: Sign:_________________________ Print: FORM EFFECTIVE 5/06/17 F:\CLER\CLER\000_ELECTION\aaFORMS\Initiative Petition for Charter Amendment.docx